ITB SYNDROME IN RUNNERS

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One of the silver linings of 2020 was that as a society we were forced to examine our health choices and acknowledge the significant consequences those choices have on our bodies.

An overwhelmingly encouraging byproduct of this is seeing so many people take up and begin to enjoy running. Unfortunately, as the universe demands balance in all things, as Physio’s we are now seeing a tonne of runners in the clinic who are new to the battle of the ongoing niggles that come as a result of increasing one’s running load.

In particular, one thing we see a lot of is lateral knee pain, and more specifically, ITB friction syndrome. ITB syndrome describes the irritation someone might get as the iliotibial band snaps over the lateral femoral condyle. The friction between these two structures provokes pain on the outside of the knee as it flexes or extends past 30 degrees of knee flexion. What this means is that it hurts to run, as every step you take your ITB is rubbing against your knee, and it only gets worse as you try to push through.

However, all hope is not lost, as there are ways to address the injury initially and reduce the likelihood of it from coming back again. The most important step is look back at your workload over the past 2-4 weeks and observe how much running you have been doing. Has it increased sharply? Have you started running further or faster? These are things that we are going to need to address and gradually increase as we get back to running.

Then take a look at your hip abductor strength and trunk stability, particularly in muscles like gluteus medius. An easy way to do this at home is to compare how many strict (emphasis on strict) sidelying leg raises you can do each side. If it’s below 30 repetitions then you most likely have room to improve. Exercises like toe taps and hip hitches are great ways to start working on hip control.

As well as muscle strength your motor control as you run and land on the affected leg can also play a significant role in your overall presentation. An unstable hip often in too much internal rotation can place the limb in a mechanically less advantageous position. Exercise repetition, footwear and some simple cues regarding running cadence and stride can help address some of these factors.

It is important to note, however, that muscle strength and motor control are not necessarily a death sentence as many elite runners don’t look technically great in stride. It really highlights the emphasis other lifestyle factors like stress, sleep, diet and general wellbeing have on your unique pain presentation; all great domains for self reflection.

At LIFT. we share a love for movement and understand that by taking that away from someone we take away a part of who they are as well. If you’re struggling with injuries and having difficulty running, get in touch with one of our Physio’s and start making yourself bulletproof!

Dan Ryles

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